2019  National  Adult  and  Influenza  Immunization  Summit  – 5/16/2019 1

American Pharmacis ts Association

Communication   Challenges,  Opportunities  &  Strategies  in  Pharmacies  –The  Flu  Season  Experience

May  2019NAIIS  Conference

Speaker:     Mitchel  C.  Rothholz,  RPh,  MBAChief  Strategy  OfficerAmerican  Pharmacists  Association

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Focus  of  Discussion

1)    Discuss   current  and  future  needs  regarding  messaging  by  pharmacists  and  the  immunization  neighborhood   regarding  influenza  vaccination.  2)  Discuss   the  importance  of  unity  and  consistency  in  communications  within  the  immunization  neighborhood.

2019  National  Adult  and  Influenza  Immunization  Summit  – 5/16/2019 2

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Vision  for  Immunizing   Pharmacists

Pharmacists  are  an  accessible,  valued  and  recognized member  of  the  immunization  neighborhood   who  is  authorized  and  compensated  for  providing  immunization  service  related  to  ACIP  recommended  vaccinations  that  improve  public  health.

Training

Advocacy

ResourcesResearch

Information

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Immunization  NeighborhoodCollaboration,  coordination,  and  communication   among  immunization   stakeholders  dedicated  to  meeting  the  immunization   needs  of  the  patient  and  protecting  the  community   from  vaccine-­‐preventable  diseases.  

Coined  by  APhA  in  2012

NVAC  Adult   Immunization  Practice  StandardsCalls  to  action  for  healthcare  professionals

Assess  immunization   status  of  all  patients   in  every  clinical   encounter.Strongly  Recommend vaccines  that  patients   need.Administer   needed  vaccines  or  Refer to  a  provider  who  can  immunize.Document   vaccines  received  by  patients,   including  entering  immunizations   into   immunization  registries.

Assess

Recommend

Administer  /  Refer

Document

2019  National  Adult  and  Influenza  Immunization  Summit  – 5/16/2019 3

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Source:    MMWR  Aug  2018  -­‐ https://www.cdc.gov/mmwr/volumes/67/rr/rr6703a1.htm

…vaccination should be offered by the end of October.

Community vaccination programs should balance maximizing likelihood of persistence of vaccine-induced protection through the season with avoiding missed opportunities to vaccinate or vaccinating after onset of influenza circulation occurs.

Although  delaying  vaccination  might  result  in  greater   immunity  later   in  the  season,  deferral  also  might  result  in  missed  opportunities  to  vaccinate,  as  well  as  difficulties  in  vaccinating  a  population  within  a  more  constrained  time  period.  Efforts  should  be  structured  to  optimize  vaccination  coverage  before   influenza  activity  in  the  community  begins.

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JAN DEC

FebruaryBegin  planning  season  plan  

based  on  CDC  rec  and  other  input

Vaccine  ordering  (Feb  – May) Offering  vaccination  (Aug  – Apr/May)  ordering  (Feb  – May)

MMWR  – Aug  2018

• Need  clarity,    consistency  and  understanding  in  regarding  to  timing  for  vaccine  administration• Communication  between  members  of  immunization  neighborhood

• Is  there  a  preferred   timing  of  vaccination  within  the  community  or  a  practice’s  patients?• Has  the  practice  communicated  to  their  patients  their  preference   for  timing?

• How  would  primary  care  providers  like  to  be  informed  of  vaccinations?• Is  everyone   reporting  to  and  accessing  IIS?  

When  will  CDC  messaging  and  guidance  be  provided  to  practitioners?

Media  planning,  buys,  and  launch

2019  National  Adult  and  Influenza  Immunization  Summit  – 5/16/2019 4

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New  Best-­‐seller  Series  -­‐Time  to  tell  the  story• Patient  stories• Burden  of  season• Workforce   impact• Hospitalizations• Deaths• Risk  to  Community• Message  opportunity

• Walk-­‐the-­‐walk

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How  do  we  communicate  Vaccine  Efficacy  and  Real-­‐World  Experience  to  overcome  vaccine  hesitancy?• Many  factors  impact  VE  /  Real  World  Experience

• Double-­‐edged  sword:  Percentages  vs  observational  impact• VE  numbers  could  be  better  and  we  can’t  sit  back  because  • as  VE  improves,  burden  of  disease  reduces,  and  importance  of  vaccination  may  be  impacted

• Vaccine  effectiveness  29%  in  acute  MI  prevention• “On  par  or  better  than  accepted  preventive  

measures  [as]  statins  (36%),  anti-­‐hypertensives  (15–18%),  and  smoking  cessation  (26%)”

1.  Barnes  M,  et  al.  Acute  myocardial  infarction  and  influenza:  a  meta-­‐analysis  of  case–control  studies.  Heart  2015;101:1738–17472.  Udell JA,  et  al.  Association  between  influenza  vaccination  and  cardiovascular  outcomes  in  high-­‐risk  patients:  a  meta-­‐analysis.  JAMA  2013;310:1711–20

2019  National  Adult  and  Influenza  Immunization  Summit  – 5/16/2019 5

American Pharmacis ts Association

Understanding  how  to  communicate

Pharmacists  are  no  different  than  any  other  providers• Challenged   with   understanding   the  data  and  how   to  communicate   it   effectively  to  the  public

q Consistent  messaging  across  the  immunization  neighborhood  is  a  necessityq Put  a  face  on  the  story  for  why  people  should  get  immunized  (Reduces  symptoms  and  illness  length  – Key  

messages)q Education,  repeat  of  messages,  life  experiences  all  influence  health  care  providers

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ü All  individuals  who  administer  a  vaccine  should  input  data  into  the  IIS,  so  that  a  full  record  is  available  for  reference  and  unnecessary  vaccine  administration  is  avoided.

ü As  part  of  Pharmacists’  Patient  Care  Process:    proactively  assess  a  patient’s  immunization  history  at  any  patient  visit,  and  where  available,  assess  data  within  IIS.    Requirements  for  reporting  of  vaccination  data  should  be  consistently  applied  across  all  immunization  providers.

ü Pharmacists  should  continue  educating  patients  about  the  importance  of  tracking  their  vaccine  history  and  how  their  information  may  be  stored  electronically  for  other  vaccine  providers  to  access  through  an  IIS.

Source:    Pharmacists:  Advancing  Core  Elements  of  the  Immunization  Neighborhood  and  the  Adult  Immunization  Standards  

funded  by  the  CDC   Cooperative  Agreement  number  H23IP000984   ,  2015-­‐2017  report   produced   September  2017

Pharmacists  and  Documentation  /  IIS

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2019  National  Adult  and  Influenza  Immunization  Summit  – 5/16/2019 6

American Pharmacis ts Association

Increase  public  understandingCommunication  /  Documentation  engagement  of  providers  and  patients

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Communication  is  a  two-­‐way  street.